Study on nursing intervention for pain management after orthognathic surgery in oral and maxillofacial surgery
口腔颌面外科正颌术后疼痛管理的护理干预研究

摘要

目的 探究基于科室现有止痛手段（止疼泵、丙帕他莫、散利痛、冰敷）的综合护理干预在口腔颌面外科正颌术后疼痛管理中的效果，为优化术后疼痛护理方案提供依据。方法 选取2024年6月-2025年6月在我院行正颌手术的148例患者，按随机数字表法分为对照组（74例）与实验组（74例）。对照组采用常规疼痛护理，包括按需使用止疼泵、丙帕他莫或散利痛；实验组实施综合护理干预，在常规止痛基础上增加疼痛动态评估、个性化冰敷指导及心理干预。比较两组术后24h、48h疼痛视觉模拟评分（VAS）、止痛药物额外使用次数及护理满意度。结果 实验组术后24h、48h VAS评分（2.31±0.58）分、（1.85±0.46）分，低于对照组（3.86±0.72）分、（3.02±0.61）分（t=14.256、11.873，P＜0.001）；实验组止痛药物额外使用次数（0.42±0.21）次，少于对照组（1.56±0.38）次（t=22.345，P＜0.001）；实验组护理满意度（97.30%）高于对照组（83.78%）（χ²=9.862，P=0.002）。结论 综合护理干预可有效减轻正颌术后疼痛，减少止痛药物使用，提升护理满意度，具有临床推广价值。

Abstract

Objective To explore the effect of comprehensive nursing intervention based on the department’s existing analgesic methods(patient-controlled analgesia pump, propacetamol, compound paracetamol and codeine phosphate tablets, ice compress)on pain management after orthognathic surgery in oral and maxillofacial surgery, and to provide a basis for optimizing the postoperative pain nursing plan.
Methods A total of 148 patients who underwent orthognathic surgery in our hospital from June 2024 to June 2025 were selected and divided into a control group(74 cases)and an experimental group(74 cases)using the random number table method. The control group received routine pain nursing, including on-demand use of patient-controlled analgesia pump, propacetamol or compound paracetamol and codeine phosphate tablets; the experimental group received comprehensive nursing intervention, which added dynamic pain assessment, personalized ice compress guidance and psychological intervention on the basis of routine analgesia. The Visual Analogue Scale(VAS)scores at 24h and 48h after surgery, the additional use times of analgesic drugs and nursing satisfaction were compared between the two groups.
Results The VAS scores of the experimental group at 24h and 48h after surgery were(2.31±0.58)and(1.85±0.46),which were lower than those of the control group[(3.86±0.72)and(3.02±0.61)](t=14.256,11.873, P＜0.001);the additional use times of analgesic drugs in the experimental group was(0.42±0.21),which was less than that in the control group[(1.56±0.38)](t=22.345,P＜0.001);the nursing satisfaction of the experimental group (97.30%) was higher than that of the control group (83.78%) (χ2=9.862, P=0.002).
Conclusion   Comprehensive nursing intervention can effectively relieve pain after orthognathic surgery, reduce the use of analgesic drugs, and improve nursing satisfaction, which has clinical promotion value.